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The construction and assessment of a simulation model to describe the impact of dietary change on the epidemiologic transition and its consequences in China.

机译：描述食物变化对流行病学转变及其在中国后果的模拟模型的构建和评估。

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The dietary pattern in rural China during the early 1980's was still largely staple grain-based, but the dietary habits of the population are changing rapidly. The typical direction of dietary change for industrializing countries is toward a diet high in fat, rich in animal foods and low in fiber. It is not clear that this is a desirable end point in terms of public health and other societal consequences.; To assess the impact of dietary change, a model was constructed allowing predictions of chronic disease rates that result as a consequence of changes in nutritional experience for the population. Several analytic strategies (OLS regression, factor analysis, and threshold testing) were used to establish relationships among 11 prominent chronic diseases and the key elements of dietary exposure in an ecologic study of 65 rural Chinese counties. These analyses provided only partial models. A modified meta-analysis was performed to determine what modifications of the initial models would allow the final result to take into account the role of other well established determinants of disease rates.; Following completion of the models, several simulation scenarios were constructed to allow for the comparison of alternative potential future dietary patterns in terms of chronic disease outcomes. The three scenarios receiving primary interest had distinct dietary characteristics. The first was a staple grain-based diet, the second was a Western-style, animal food-based diet, and the third was a diversified, plant-based diet.; The simulation models projected much higher rates of premature mortality from chronic disease under the Western-style diet scenario than under the diversified plant-based diet scenario (2.12 million vs. .28 million premature deaths per year). These projected rates of mortality suggest the cost to the health care system of treating disease would be 6.95 times higher under the animal food-based diet scenario than under the plant-based diet alternative. These rates of mortality also suggest an annual loss of productive output to premature death of at least {dollar}9.69 billion (US) compared to only {dollar}1.33 billion with the plant-centered diet.
机译：1980年代初期，中国农村地区的饮食模式仍主要以谷物为主，但人口的饮食习惯正在迅速改变。工业化国家饮食改变的典型方向是朝着高脂肪，富含动物性食物和低纤维的饮食。就公共卫生和其他社会后果而言，尚不清楚这是否是理想的终点。为了评估饮食变化的影响，构建了一个模型，可以预测由于人口营养经验变化而导致的慢性疾病发生率。在65个中国农村县的一项生态学研究中，使用了几种分析策略（OLS回归，因子分析和阈值测试）来建立11种突出的慢性病与饮食暴露关键要素之间的关系。这些分析仅提供了部分模型。进行了改进的荟萃分析，以确定对初始模型的哪些修改将使最终结果考虑到其他公认的疾病发生率决定因素的作用。在完成模型之后，构建了几种模拟方案，以根据慢性病结局比较未来可能的其他饮食模式。受到主要关注的三种情况具有不同的饮食特征。第一种是基于谷物的主食，第二种是基于动物食品的西式饮食，第三种是基于植物的多样化饮食。模拟模型预测，在西式饮食方案下，慢性疾病引起的过早死亡的发生率要比在多种植物性饮食方案下的高（分别为每年212万和.28百万）。这些预计的死亡率表明，在以动物食物为基础的饮食方案下，治疗疾病的医疗保健系统的费用将比在以植物为基础的饮食方案下高6.95倍。这些死亡率也表明，过早死亡导致的生产性产出每年损失至少96.9亿美元（美国），而以植物为中心的饮食则仅为13.3亿美元。

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